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Wiley InterScience | ||||||||||||||||
  Journal of the European Academy of Dermatology and VenereologyVolume 23 Issue 8, Pages 896 - 904 Published Online: 3 May 2009 Journal compilation © 2010 European Academy of Dermatology and Venereology Published on behalf of the European Academy of Dermatology and Venereology
Abstract | References | Full Text: HTML, PDF (Size: 386K) | Related Articles | Citation Tracking  ORIGINAL ARTICLE Sustained improvement in joint pain and nail symptoms with etanercept therapy in patients with moderate-to-severe psoriasis Copyright Journal compilation © 2009 European Academy of Dermatology and Venereology KEYWORDS etanercept • joints • nails • open-label study • psoriasis • quality of life ABSTRACTBackground To determine the prevalence of joint and nail symptoms, impact of these symptoms on health-related quality of life (HR-QoL), and the effects of etanercept on them in patients with moderate-to-severe plaque psoriasis. Methods In CRYSTEL, patients with psoriasis received etanercept continuously (n = 357) or as paused therapy (n = 363) for 54 weeks. In post hoc analyses, baseline characteristics and after-treatment changes were evaluated in patients with baseline joint pain or nail psoriasis, pooling across treatment groups. Assessments of symptom severity and HR-QoL included the Subject Global Assessment question on joint pain, NAPSI, DLQI and EQ-5D. Results Of 711 patients, 64% reported joint pain and 79% nail psoriasis at baseline. Patients with baseline joint pain or nail psoriasis had significantly worse HR-QoL than unaffected patients. Mean baseline differences between patients with and without joint pain in DLQI (3.3), EQ-5D utility (0.2), and EQ-5D VAS (7.3) were clinically meaningful. In patients with nail psoriasis, a clinically meaningful difference in EQ-5D VAS (5.0) was seen. Etanercept significantly improved symptom severity and HR-QoL. Patients with joint pain had improvements of 47%, 61%, 29%, and 23% in mean joint pain score, DLQI, EQ-5D utility, and EQ-5D VAS, respectively, at Week 54. Patients with nail psoriasis had improvements of 51%, 63%, and 24% in NAPSI, DLQI, and EQ-5D VAS. Conclusion In this study of moderate-to-severe plaque psoriasis, joint and nail symptoms were prevalent and patients with these symptoms had significantly greater HR-QoL impairment at baseline than unaffected patients. Etanercept provided significant improvement in symptom severity and HR-QoL. Conflict of InterestT. Luger has acted as a paid consultant to and speaker for Wyeth Pharmaceuticals. J. Barker has acted as a paid consultant to and speaker for, and has received unrestricted research or education support from Wyeth Pharmaceuticals. J. Lambert has acted as a paid consultant to and speaker for Wyeth. S. Yang, D. Robertson, J. Foehl, C. Molta, and R. Boggs are employed by Wyeth Pharmaceuticals, which supported this study financially. Received: 11 December 2008; Accepted 7 January 2009 | 
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